A mysterious case of unusual CT imaging artefacts: a clinici
The present case has been reported in the Indian Journal of Anaesthesia.

A 36-year-old woman, married for 14 years was admitted with history of headache, giddiness and forgetfulness for 4 months, and difficulty in walking for 2 days. She had never conceived and her last menstrual period was 15 days ago. On examination, the patient had an exaggerated right knee-jerk reflex and unsteady gait.

CT showed a left parieto-occipito-temporal glioma with subfalcine and uncal herniation. Pregnancy test was not performed as the husband and wife were sure about the menstrual history. The potential for conception in the intervening period after the last menses, perioperative risk of miscarriage and teratogenicity were explained.

She underwent an emergency craniotomy and excision of the tumour successfully under general anaesthesia. A right subclavian central venous catheter (CVC) was inserted intraoperatively. A routine chest radiograph obtained postoperatively to confirm the CVC position revealed the outline of a foetus apparently lying within the patient's abdomen.

The menstrual history was reconfirmed from the husband. Close examination of the radiograph revealed soft tissue outline of a foetus lying transversely within the patient's abdomen with the foetal head to the right side facing cranially, limbs stretched out and the foetal back oriented caudally.

A radiologist was consulted for clarification of the radiograph. Further investigation revealed positive history that the chest radiograph of this patient was preceded by a previous exposure of the same imaging plate (IP) for a radiograph of a stillborn foetus. Therefore, the image of the foetus was an artefact in the chest radiograph of this patient.

Major takeaway:-
- With the growing use of the computed and digital radiography, anaesthesiologists, especially those working in intensive care units and emergency rooms, may encounter clinical scenarios requiring urgent interpretation of radiographic images.

- These clinicians need to be aware of the radiographic imaging artefacts that can have immediate diagnostic and therapeutic implications.

- This image serves as an example of the different forms of imaging artefacts that can compromise radiographic interpretation.

Read more about the case here: https://pxmd.co/2sqSt
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